Which of the following is not a symptom of depression?

RRB Staff Nurse Delhi-2015

Mental Health Nursing

Medium

Appeared in: RRB Staff Nurse Delhi-2015

Explanation

Delusion of grandiosity is a false belief in one's own superiority, special powers, or importance.
This symptom is a hallmark feature of a manic episode, which is characteristic of Bipolar Disorder.
It is considered a 'mood-congruent' delusion for mania because it aligns with the elevated, expansive mood state.
Depression is characterized by low mood and low self-esteem, making grandiosity fundamentally inconsistent with its clinical picture.

Option A: Loss of interest or pleasure in almost all activities (anhedonia) is a core diagnostic criterion for Major Depressive Disorder.
Option B: Feelings of worthlessness or excessive/inappropriate guilt are common in depression. In severe, psychotic depression, these can manifest as delusions of guilt.
Option C: Recurrent thoughts of death, suicidal ideation, or suicide attempts are a key and serious symptom of Major Depressive Disorder.

Visual 1: Comparison Chart - A side-by-side chart listing the contrasting symptoms of a major depressive episode versus a manic episode, highlighting mood, self-esteem, sleep, and thought content.
Visual 2: Infographic - An infographic titled 'The Spectrum of Mood Disorders' showing depression and mania as opposite poles, with key symptoms listed under each.

Clinical Relevance

Nursing practice connection: Knowing Differential diagnosis of mood disorders, specifically distinguishing symptoms of depression from mania helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Accurately identifying symptoms is crucial for differentiating between unipolar depression (Major Depressive Disorder) and Bipolar Disorder.
Misdiagnosing Bipolar Disorder as unipolar depression and prescribing antidepressants without a mood stabilizer can trigger a manic episode, which can be dangerous for the patient.
What if? If a patient presenting with depression also reports periods of elevated energy, decreased need for sleep, and racing thoughts, the nurse must suspect Bipolar Disorder and ensure this is communicated to the healthcare team for a full psychiatric evaluation.

How to Approach the Question

First, identify the core concept of the question, which is the symptoms of 'depression'.
Note the negative keyword 'not'. This means you are looking for the option that does NOT fit the diagnosis of depression.
Evaluate each option: Ask yourself, 'Is this a known symptom of depression?'
Option A (Loss of interest): Yes, this is a core symptom (anhedonia).
Option B (Delusion of guilt): Yes, this can occur in severe, psychotic depression.
Option C (Suicidal ideas): Yes, this is a critical symptom.

Concept Tested & Keywords

Concept Tested: Differential diagnosis of mood disorders, specifically distinguishing symptoms of depression from mania.
Stem keywords: symptom, depression
Lead-in keywords: not
Negative lead-in flag: This question uses negative framing ('NOT'), asking you to identify the option that is an exception.

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